A number of barriers, both real and perceived, tend to hinder the recruitment of patients, and by extension, minorities and poor people into clinical oncology trials at community centers. In order to initiate the opportunity to participate in clinical research at the community level, we have developed a collaborative regional network, The Radiation Oncology Community Outreach Group (ROCOG), based at UPMC McKeesport Hospital, that will build the infrastructure for clinical research at five community hospitals over the term of the grant, and which will deploy infrastructure resources for widespread, clinically and demographically disparate populations. Project goals include increasing clinical compliance, protocol recruitment and protocol retention within these populations, operationalizing a collaborative model of community based research, testing the efficacy of patient identification, engagement and outreach models and using a comprehensive outcomes measurement system to insure care quality and monitor treatment disparities. This proposal presents a number of other unique approaches and strengths. Several potential academic "mentors" have provided their endorsement, including the University of Pittsburgh Cancer Institute, Allegheny General Hospital Cancer Institute, Roswell Park Cancer Institute and the Mallincrodt Institute of Radiology at Washington University at St. Louis. The proposal also has the support of several well-recognized minority health initiatives within western Pennsylvania, to assist us in outreach and disparities education. Our outreach strategies are tailored to urban or to rural areas, and include use of a new "fast track" patient identification function within Tumor Registry, Patient Navigator system, Protocol Nurse and contracted community outreach agencies. The proposed clinical pilots concerning breast conservation, colorectal and bone mets reflect locally-specific high burden of disease within minority populations. An integrated outcomes monitoring system using Tumor Registry & Record & Verify data is also proposed as a platform for a comprehensive CQI program. Finally, comprehensive patient and professional education will be provided through a combination of peer outreach, WEB-based programming and through a mobile application of the NCI Telesynergy system.